Outcomes of Computed Tomography-Guided Image-Based Interstitial Brachytherapy for Cancer of the Cervix Using GEC-ESTRO Guidelines

The clinical value of ultrasound-guided sacral anesthesia in Intracavitary and/or interstitial brachytherapy for cervical Cancer

OBJECTIVE

To explore the effectiveness and safety of ultrasound-guided sacral anesthesia in intracavitary and/or interstitial brachytherapy for cervical cancer patients.

METHOD

A retrospective analysis was conducted on a total of 1039 intracavitary and/or interstitial brachytherapy involving 220 patients in our department from December 7, 2020 to March 21, 2024. The study assessed the satisfaction with anesthesia, changes in vital signs, onset time of anesthesia, dosage of anesthetic drugs, duration of anesthesia, and incidence of adverse reactions.

RESULT

The rate of satisfaction with anesthesia was 73.8 %. There were no significant differences in patients' heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), or oxygen saturation (SaO2) before and after anesthesia (P > 0.05). The onset time of anesthesia ranged from 20 to 35 min, the average dosage of anesthetic was 20 ml, and the duration of anesthesia lasted from 30 to 120 min. Serious adverse reactions included 2 cases of post-anesthesia syncope (associated with sacral cysts). The incidence of nausea was 2.2 %, and the total incidence of other adverse reactions, such as vomiting, urinary retention, bradycardia, anal discomfort, and dizziness, was less than 1 %.

CONCLUSION

Ultrasound guided sacral anesthesia demonstrates significant advantages, including effective anesthesia, minimal impact on vital signs, rapid onset, prolonged maintenance, and a low incidence of adverse reactions. It is recommended for widespread application in intracavitary and/or interstitial brachytherapy for cervical cancer patients.

Role of Cervical Cancer Radiotherapy in the Expression of EGFR and p53 Gene

Background:

Cervical cancer arises from the cervix and it is the 3rd most diagnosed malignancy and a foremost cause of cancer-related death in females. On the other hand, the expressions of EGFR and p53 are two important proteins observed in various studies on cervical cancer.

Objective:

The study aims to evaluate the beneficial effect of radiotherapy based on the regulation of p53 and EGFR gene in patients with cervical cancer.

Methods:

In this investigation, the regulation of important molecules responsible for cancer cell proliferation and DNA repair in the cervical cancer cell line was evaluated. The study comprises of an evaluation based on clinical study design from the malignant biopsies of 15 cervical cancer patients. The patterns of expression for the p53 gene and Epidermal Growth Factor Receptor (EGFR) were evaluated in DoTc2 and SiHa cervical cancer cell lines using clonogenic assay, western blotting and immunohistochemistry techniques from the malignant biopsies of the 15 patients.

Results:

The study observed that the regulation of p53 and EGFR was very weak after the exposure of the radiation. In addition, the expression of p53 and EGFR was observed in malevolent biopsy samples after radiation with a dosage of 1.8 Gy radiations. Additionally, the expression of p53 and EGFR was able to induce by a single dose of radiotherapy in the malignant biopsies whereas it was unable to induce in DoTc2 and SiHa cervical cancer cells.

Conclusion:

The study observed that radiation exposed cancer cell lines modulates the expression of p53 and EGFR gene. The study also highlights the gap between in vitro experimental models and clinical study design.